Exploration of Barriers to the Uptake of Nutritional Services Among Adolescent Girls from the Rural Communities of Tigray Region, Northern Ethiopia: A Qualitative Study

Amaha Kahsay; Hadush Gebregziabher; Znabu Hadush; Dejen Yemane; Abebe Hailemariam; Afework Mulugeta

doi:10.2147/AHMT.S276459

Exploration of Barriers to the Uptake of Nutritional Services Among Adolescent Girls from the Rural Communities of Tigray Region, Northern Ethiopia: A Qualitative Study

Adolesc Health Med Ther. 2020 Oct 22:11:157-171. doi: 10.2147/AHMT.S276459. eCollection 2020.

Authors

Amaha Kahsay¹, Hadush Gebregziabher¹, Znabu Hadush², Dejen Yemane², Abebe Hailemariam³, Afework Mulugeta¹

Affiliations

¹ Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
² Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
³ UNICEF Head Office, Addis Ababa, Ethiopia.

Abstract

Background: Adolescence is a time of tremendous physical growth and mental development, with high nutrient requirements. Ethiopia is among the countries with a high prevalence of nutritional deficiencies among the women of reproductive age group, whilst adolescent girls from rural areas suffered disproportionately. However, there is a dearth of evidence regarding the barriers that hinder adolescent girls to utilize the available nutritional services.

Purpose: The current study aimed to qualitatively explore the range of barriers for the uptake of nutritional interventions among adolescent girls in rural communities of Tigray, Northern Ethiopia.

Methods and participants: We employed an explorative qualitative study among purposively selected adolescent girls and school teachers from rural districts of Tigray region. We conducted 11 focused group discussions with adolescent girls, 17 in-depth interviews (seven with teachers, seven with in-school adolescent girls, and three with out-of-school adolescent girls) using a semi-structured guide. Data was audio-taped, transcribed verbatim in local language, translated into English, and imported into ATLAS.ti version 7.5 qualitative data analysis software for analysis.

Results: Adolescents perceived that stunting, anemia, and thinness are among the main nutritional problems in their community. Food insecurity, limited nutrition awareness in the community, limited access to a water source, high workload, service provider's little attention for adolescents' nutrition, and food taboo have emerged as barriers for the uptake of adolescent girls' nutritional interventions. Though limited in reach, available nutritional interventions include awareness creation, nutritional supplementation, and disease prevention.

Conclusion: Food insecurity poses a strong challenge to adolescent girls' nutrition. As access to safe drinking water continues to be a considerable bottleneck for nutritional interventions, a multi-sectoral response to integrate water, sanitation, and hygiene (WASH) services is required. Bounded by food taboo, high burden of workload among the adolescent girls, women empowerment and nutritional status seem to be the unfinished agenda in resource limited settings such as the rural areas of Tigray region.

Keywords: Ethiopia; Tigray; adolescent girls; barriers; nutritional services; rural.

Grants and funding

This research work is funded by the UNICEF and Tigray Regional Health Bureau. But, these organizations had no role in the design, analysis, or writing of this article.